不同程度糖尿病肾病患者胱抑素C水平的变化及临床意义  

Study on the Changes of Cystatin C Levels in Patients with Diabetic Nephropathy of Various Degrees and Its Clinical Significance

作　　者：李永国[1] 曾娇娥[1] 宁尚侠[1] 

机构地区：[1]荆州市中心医院内分泌科,湖北荆州434020

出　　处：《医学综述》2015年第10期1888-1890,共3页Medical Recapitulate

摘　　要：目的分析并评价不同程度糖尿病肾病患者胱抑素C水平变化及临床意义。方法荆州市中心医院自2012年2月至2013年10月共收治98例2型糖尿病患者,根据尿微量白蛋白（m ALB）水平按照国际糖尿病肾病Mogensen分期标准将全部患者分为3组：正常白蛋白尿组29例（m ALB〈30 mg/d）;微量白蛋白尿组33例（m ALB 30-300 mg/d））;大量白蛋白尿组36例（m ALB≥300 mg/d）。另选取本院同期体检者32例健康人群作为健康对照组。对各组的血浆胱抑素C、血肌酐定量进行测定,对比分析各组内生肌酐清除率（Ccr）,并对各组尿m ALB、胱抑素C、血肌酐及Ccr水平进行相关性分析。结果大量白蛋白尿组、微量白蛋白尿组、正常白蛋白尿组、健康对照组m ALB分别为（356.1±45.3）、（68.8±34.0）、（14.3±2.6）、（11.5±3.0）mg;尿胱抑素C分别为（2.42±0.69）、（1.91±0.78）、（1.05±0.17）、（0.88±0.22）mg/L;尿血肌酐分别为（99±32）、（70±18）、（83±16）、（76±18）μmol/L;Ccr分别为（1.9±0.4）、（2.6±0.4）、（2.8±0.6）、（2.7±0.6）m L/s。其中微量白蛋白尿组和大量白蛋白尿组患者血浆胱抑素C与尿m ALB水平均明显高于正常白蛋白尿组和健康对照组（P〈0.01）,且大量白蛋白尿组尿m ALB和胱抑素C水平显著高于微量白蛋白尿组（P〈0.01）。胱抑素C与m ALB呈显著正相关（r=0.769,P=0.008）,与血肌酐呈显著正相关（r=0.779,P=0.007）。胱抑素C与Ccr呈显著负相关（r=-0.749,P=0.012）,血肌酐与Ccr呈显著负相关（r=-0.668,P=0.021）。结论血浆胱抑素C水平变化可指示2型糖尿病患者的肾功能改变,提倡将其作为糖尿病肾病的参考指标。Objective To analyze and evaluate the changes of Cystatin C levels in patients with diabetic nephropathy of various degrees and its clinical significance.Methods A total of 98 patients with type 2 dia-betes admitted in Jingzhou Central Hospital from Feb.2012 to Oct.2013 were selected and divided into 3 groups according to their levels of urinary albumin in accordance with international Mogensen staging criteria：normal albuminuria group [ 29 cases, micro-albuminuria （ mALB ） 〈30 mg/d ];microalbuminuria group （33 cases,mALB 30-300 mg/d）;macroalbuminuria group（36 cases,mALB≥300 mg/d）.Another 32 cases of healthy people underwent physical examination in the hospital during the same period were selected as the control group.Plasma cystatin C,serum creatinine（Scr） of all the groups were quantitatively determined, endogenous creatinine clearance rate（Ccr） of all the groups were comparatively analyzed,and the correlation of urine mALB,Cystatin C,serum creatinine and Ccr levels was analyzed.Results In macroalbuminuria group,microalbuminuria group, normal albuminuria group and control group, mALB levels were （ 356.1 ± 45.3）,（68.8 ±34.0）,（14.3 ±2.6）,（11.5 ±3.0） mg,respectively;urinary cystatin C levels were （2.42 ± 0.69）,（1.91 ±0.78）,（1.05 ±0.17）,（0.88 ±0.22） mg/L,respectively;urine creatinine levels were （99 ±32）,（70 ±18）,（83 ±16）,（76 ±18） μmol/L respectivley;Ccr levels were （1.9 ±0.4）,（2.6 ± 0.4）,（2.8 ±0.6）,（2.7 ±0.6） mL/s,respectively.The plasma cystatin C and urinary mALB levels in albuminuria group and macroalbuminuria group were significantly higher than the normal albuminuria group and the control group （P〈0.01）,and urine mALB level and serum cystatin C level in albuminuria group were significantly higher than those in microalbuminuria group（P〈0.01）.There was a significantly positive correlation between cystatin C and mALB（r=0.769, P=0.008）,there was a significantly positive correla-tion between c

关 键 词：糖尿病肾病 白蛋白尿 胱抑素C 血肌酐 肌酐清除率 

分 类 号：R587.1[医药卫生—内分泌]